Congenital Hand Conditions
About 10% of children are born with a malformation of the hand. Congenital deformities in a newborn are distressing. They may be observable in utero and will be noticeable at birth. They can generate feelings of anger and guilt in parents, but they do not run in families (are not caused by genetics), are not preventable and often cannot be detected before birth. It is important for the parents to understand why congenital hand conditions occur to alleviate guilt and anger and help them better support their child.
What are congenital hand conditions?
Also known as birth defects, they are abnormalities of the hand that are present at birth. The most common type of congenital hand deformity is a thumb anomaly, which affects the size, shape, and function of the thumb. Other types of congenital hand deformities include:
- syndactyly (webbing between the fingers)
- polydactyly (extra fingers)
- adactyly (missing fingers)
- Radial club hand where the small bone in the forearm is malformed shortening and curving the forearm to create a J shaped club with a small or absent thumb which interferes with function.
- Cleft hand where the fingers in the center of the hand are missing creating a cleft in the hand and gap in the palm. Cleft hands can be on both sides or one side, and often occur with webbing or extra fingers.
What causes congenital hand conditions?
Congenital hand deformities can be caused by a variety of factors. They often develop early in pregnancy (in the fourth to sixth week of pregnancy) when the arms, hands, fingers begin to develop. When development is interrupted due to exposure to certain medications (thalidomide), infections or toxins during pregnancy, genetics or traumatic injury to the developing hand, congenital hand conditions can result. Sometimes the cause is a genetic disorder that affects more than the hands, and sometimes it occurs for unknown reasons.
What is the impact on the child with a hand malformation?
Some babies can adapt their functioning well depending on the type and extent of the malformation. Others will face various challenges as they develop which can interfere with their motor skills, self-care abilities, and limit their ability to participate in sports and exercise.
These children often experience emotional distress related to function limitations, aesthetics, and teasing that interferes with social interaction and frustration with physical disability. Psychological screening is vital to identify stress and adjustment issues so these children can learn positive coping mechanisms to enhance self-esteem.
How are congenital hand conditions diagnosed?
Some can be diagnosed prenatally or at birth, but some do not become obvious until the child starts using their hands or arms. X-rays will be ordered to evaluate the underlying bones and an MRI may be helpful to evaluate the soft tissues including nerves and blood vessels.
Preoperative advanced imaging techniques are available to provide vital information that can affect surgical approach, prognosis, and therapeutic outcome of the child.
How is a congenital hand condition treated?
Treatment for congenital hand deformities depends on the severity of the condition and may involve orthotics like splints and braces, prosthetics like artificial limbs, physical therapy, and/or occupational therapy, and surgery. Surgery is always individualized to the needs of each patient, and may include microsurgery, and surgical reconstruction and repair.
If your child has a congenital hand deformity, it is important to seek treatment from a qualified healthcare provider. With proper treatment, most people with congenital hand deformities can live normal, productive lives.
The pediatric orthopedic surgeons at Ortho Illinois are here for you to help you cope with and receive the expert advice and treatment you need for your precious child. We have the skills and experience to provide the care your child needs to succeed in life. Contact us to learn more.